Puerto Rico Prepares for Zika Epidemic

By the end of 2016, 25% of Puerto Rico’s 3.5 million inhabitants are expected to become infected with the Zika virus, according to the Centers for Disease Control and Prevention. To help prevent the spread of the mosquito that carries Zika, local governments — along with the CDC — are spraying communities with insecticides, removing old tires and other detritus that can serve as breeding grounds, and covering open-air windows with screens to keep mosquitos out.

These efforts are focused especially on protecting pregnant women, because of the possible connection between Zika infection during pregnancy and infant microcephaly. The island’s birth rate is 10 per 1,000 women, nearly 20% of whom are high school girls. Staff members at government-run mother-and-child nutrition clinics have been hosting information sessions for pregnant women, as well as providing materials such as DEET and mosquito netting. Unfortunately, many clinics have already run out of Zika prevention kits to provide to the women who come to their sessions.

PROTECT’s Dr. Jose Cordero discussing Zika at an information session for healthcare professionals in San Juan

PROTECT and CRECE are working with local healthcare providers to ensure they have accurate, complete information to dispense to their patients. In February, both centers hosted two major information sessions for physicians and healthcare professionals from around the island to address major misconceptions about the virus and the best practices for avoiding exposure. A local university has invited PROTECT’s Community Engagement Core to speak with students and faculty about the virus. PROTECT and CRECE have begun distributing mosquito nets to participants, both for pregnant mothers and for the babies after birth.

Zika reached Puerto Rico earlier than anticipated, and the hottest, wettest months of the year are still ahead. Whether Puerto Rico will see an increase in microcephaly cases remains to be seen, and will likely not become clear until the fall. Brazil remains the only country to demonstrate an increase in cases of microcephaly, but Panama recently confirmed the presence of Zika in a case of microcephaly and Colombia is investigating several cases.

The connection between Zika and microcephaly is still unclear, yet recent research is beginning to shed some light. A study funded by the NIH found that the Zika virus can infect and kill human neural progenitor cells, which later develop into the cerebral cortex. A second study involved a small cohort of pregnant women in Brazil who had been infected by the Zika virus. Ultrasounds of the developing babies indicated that nearly one third showed signs of severe abnormalities, including but not limited to microcephaly. These findings are only preliminary, but they suggest an urgent need for more research about Zika.

PROTECT’s Community Engagement Core will continue to distribute information about the best practices for avoiding exposure to healthcare professionals and community members. Click here to read more about PROTECT’s efforts against Zika.